P1.51 Antimicrobial resistance (AMR) and NG-MAST profile of neisseria gonorrhoeaeisolates collected from std patients from across india

IntroductionNeisseria gonorrhoeaemultiantigen sequence typing (NG-MAST) is a highly discriminatory technique for assessing the genetic diversity of N. gonorrhoeae(NG) and has also been put forward as a tool for predicting specific antimicrobial resistance (AMR) phenotypes. In light of the above, the present study was undertaken to investigate the molecular epidemiology of NG in India and to examine if it can be used as a means for predicting AMR.MethodsA total of 204 consecutive NG isolates collected between April 2010 - October 2013 were investigated. Antimicrobial susceptibility testing was done using disc diffusion method and E test and the results interpreted using the breakpoint criteria of CDS technique. NG-MAST was performed as described previously. WHO N. gonorrhoeaereference strains F, G, K-P were used as controls. Association between NG-MAST sequence type (ST) and antimicrobial susceptibility was probed using χ2and fisher’s exact tests.ResultsRates of resistance to classical antibiotics were high. Decreased susceptibility (DS) to ceftriaxone (MIC 0.032–0.25 µg/ml) was seen in 7.3% while azithromycin resistance (MIC ≥1 µg/ml) in 2.5% isolates. A total of 202 NG isolates were assigned into 108 different STs while 2 were not typable, The high genetic diversity arose from the allelic combination of 80 porand 44 tbpBalleles and the overall mean genetic distance was 85.5 (SE 4.6) nucleotide differences. Out of 108 STs, 84 (77.8%) were novel. The majority of STs (75.9%, 82 of 108) were represented by singletons, whereas the remaining STs included between 2 and 38 isolates. The most common STs were ST6058 (n=38, 18.8%), ST2990 (n=6, 2.9%), ST6069, ST9775, ST9783, ST9875 (n=5, 2.5% each). There was a significant association between ST6058 and resistance to penicillin (p=0.00) and tetracycline (p=0.00) and ST6069 and ST 6083 and DS to ceftriaxone (p=0.00 and p=0.01 respectively). ConclusionThe present study highlights a heterogeneous gonococcal population in India. Our data, although on a limited number of NG isolates, testify to an association between genotype and AMR phenotype.